1821146630 NPI number — KAISER FOUNDATION HOSPITALS

Table of content: (NPI 1821146630)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821146630 NPI number — KAISER FOUNDATION HOSPITALS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KAISER FOUNDATION HOSPITALS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
KAISER HOSP MORSE 2ND FL PHY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821146630
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/05/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2025 MORSE AVE FL 2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SACRAMENTO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95825-2115
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2025 MORSE AVE FL 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95825-2115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-973-6279
Provider Business Practice Location Address Fax Number:
916-486-6264
Provider Enumeration Date:
01/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SPILLER
Authorized Official First Name:
LORENA
Authorized Official Middle Name:
Authorized Official Title or Position:
OP PHARMACY MGR
Authorized Official Telephone Number:
916-973-5667

Provider Taxonomy Codes

  • Taxonomy code: 3336C0002X , with the licence number:  PHY40703 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: PHA407030 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0565739 . This is a "OTHER ID NUMBER-COMMERCIAL NUMBER" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com